Nursing Elites

1. Which substance would most likely need to be restricted in patients with heart failure who use diuretics to help reduce fluid retention?

• A. potassium
• B. magnesium
• C. sodium
• D. chloride

Correct answer: C

Rationale: Sodium restriction is crucial in heart failure management to prevent fluid retention, which can worsen symptoms of heart failure.

2. Which nutrients might people who follow a vegan diet be deficient in?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamins A and D
• D. Calcium

Correct answer: C

Rationale: People who adhere to a vegan diet might indeed be deficient in vitamins A and D, which are primarily found in animal-derived foods. While vitamin B12 and calcium can also be lacking in a vegan diet, these were not choices given that would correctly answer the question. Vitamin C, on the other hand, is widely available in numerous plant-based foods, making it less likely for vegans to be deficient in it. Therefore, the correct answer is 'Vitamins A and D'. It's important to note that deficiencies can be avoided through careful meal planning or supplementation.

3. Each statement regarding the correlation between vitamin D and sun exposure is accurate, except one. Which is the exception?

• A. The body can produce sufficient amounts of vitamin D from sunlight.
• B. UV radiation can convert a precursor of vitamin D to vitamin D3 by penetrating uncovered skin.
• C. Sunscreen blocks the formation of vitamin D3.
• D. By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

Correct answer: C

Rationale: While UV radiation can penetrate uncovered skin and convert a precursor of vitamin D to vitamin D3, sunscreen does block the formation of vitamin D3. Sunscreen is recommended by dermatologists to prevent sunburn and reduce the risk of skin cancer. The other choices are correct: the body can produce sufficient vitamin D from sunlight, UV radiation can convert a precursor of vitamin D to vitamin D3, and skin generally produces less vitamin D as a person ages.

4. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

5. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

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